Anastomosis is a procedure where two separate tubular or hollow organs are surgically grafted together to form a continuous fluid channel between them. Vascular anastomosis between blood vessels creates or restores blood flow. When a patient suffers from coronary artery disease (CAD), an occlusion or stenosis in a coronary artery restricts blood flow to the heart muscle. In order to treat CAD, anastomosis is performed between a graft vessel and the affected coronary artery in order to bypass the occlusion and restore adequate blood flow to the heart muscle. This surgical procedure is known as a coronary artery bypass graft (CABG). Anastomosis may be performed in other surgical contexts, such as carotid artery bypass surgery or microvascular surgery.
Conventional anastomosis is performed by suturing two vessels together, which can be time-consuming and painstaking. More recently, anastomosis devices such as St. Jude Medical's SYMMETRY device have been introduced. These devices are noncompliant, meaning that the diameter of the device and hence the diameter of the anastomosis substantially does not change in use. However, a compliant anastomosis is preferred in many surgical situations, such as the distal anastomosis between a graft vessel and a coronary artery. A compliant anastomosis is capable of changing diameter in use, such as in response to blood flow pulsing through it. In a CABG procedure, many surgeons prefer the distal anastomosis to be compliant rather than noncompliant.